紫癜性肾炎患儿血液凝血功能的改变及肝素治疗的效果

目的研究紫癜性肾炎患儿血液凝血功能的改变及早期抗凝与低相对分子质量肝素钙(LMWHca)的治疗效果。方法选取我院86例确诊的紫癜性肾炎患儿为研究对象,另选我院同期正常体检儿童50例为对照组,比较两组D-D、PLT、Fbg、AT水平差异。将我院86例紫癜性肾炎患儿抽签随机分为观察组与对照组,两组均为43例,分别采取早期抗凝联合LMWHca治疗以及单一LMWHca治疗,比较两组治疗前后D-D、Fbg、PLT、TT、PT、a PTT、AT水平差异,同时观察紫癜性肾炎患儿与正常儿童凝血指标差异。结果肾病组患儿D-D、PLT、Fbg显著高于正常组,AT显著低于正常组,可见紫癜性肾病患儿存在明显的高凝状态;治疗前观察组与对照组各项凝血指标比较无统计学意义(P0.05),治疗后观察组D-D、Fbg、PLT与对照组比较显著较低,TT、PT、a PTT、AT与对照组比较显著较高(P0.05)。结论紫癜性肾炎患儿体内存在高凝状态,早期抗凝或低分子肝素治疗可改善凝血功能,从而缓解病情。

Changes of Blood Coagulation Function in Children with Purpura Nephritis and Effect of Heparin

Objective To study the changes of blood coagulation function in children with purpura ne-phritis and the curative effect of early anticoagulation and low molecular heparin calcium. Methods 86 chil-dren with confirmed purpura nephritis in the hospital were selected as the research objects. 50 children who re-ceived physical examination in the hospital during the same period were selected as the control group. The lev-els of D-D,PLT,Fbg and AT were compared between the two groups. The 86 cases of children with purpura nephritis were randomly divided into the observation group and the control group with 43 cases in each group. Early anticoagulation combined with low molecular heparin calcium treatment and single low molecular heparin calcium treatment were respectively inplemented in the two groups. The differences in levels of D-D, Fbg,PLT,TT,PT,aPTT and AT were compared between the two groups before and after the treatment. The difference of blood coagulation indexes in children with and without purpura nephritis was observed. Results D-D,PLT and Fbg in children with nephropathy were significantly higher than those in the the normal group while AT was significantly lower than that in the normal group. It is found that there was obvious hypercoagula-ble state in children with purpura nephritis. Before the treatment,the comparison of each index between the ob-servation group and the control group was not statistically significant(P>0. 05). After the treatment,D-D,Fbg and PLT in the observation group which were significantly lower than control group. TT,PT,aPTT and AT were significantly higher than control group. The differences were significant(P<0. 05). Conclusion There is hy-percoagulable state in children with purpura nephritis. Early anticoagulation therapy can improve the coagula-tion function,so as to ease the state of disease.